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What is the Average Employer Contribution to Health Insurance Premiums?

Jeff Griffin

One of the most common questions we receive as an employee benefits broker is how much the average employer contributes to their employees’ health insurance premiums. It’s a tough question because there are a lot of different factors involved, but luckily, there are some excellent resources available to help us source reliable answers.

In addition to our own proprietary client roster, one of our favorite resources is the annual Kaiser Family Foundation (KFF) Health Benefits Survey because it succinctly summarizes data from an accurate (and broad) representation of employers across the country and provides charts and graphs to make the information more easily digestible. This allows us to show our clients trends over long periods of time and perhaps help predict what they can expect for the upcoming year.

Here’s what the 2017 KFF Health Benefits Survey reported for employer contributions to health insurance and how the data compares to the previous benefits year.

Employer vs. Employee Contributions to Health Insurance

While these averages vary based upon a number of factors (including, but not limited to, the size of the firm, revenue, and overall cost of premiums) looking at this data can give employers a good idea of what their competitors may be offering. Remember that your employee benefits broker can help you obtain more in-depth, geographically relevant benchmarking data.

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Topics: Employee Benefits, Affordable Care Act, ACA, CFO, CHRO, PPACA

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Are Employers Required to Offer Family Health Insurance?

Jeff Griffin

At this point, everyone knows the Affordable Care Act (ACA) requires all employers with 50 or more full-time equivalent (FTE) employees to offer affordable coverage to their workforce. This requirement is called the employer mandate.

What’s less clear for some employers is to whom the coverage must be extended. Do employers have to offer family health insurance coverage? Dependent health insurance? What about coverage for spouses? The answer is pretty straightforward, so let’s dive right in and clear up all that confusion.

ACA Requirements for Employers

The ACA requires that applicable large employers (ALEs) offer affordable coverage to their full-time employees and their dependents up to age 26. However, the law makes no requirement for spousal coverage, nor does it mandate that employers pay for any portion of the premium for dependents.

So in short — employers are not required to offer family health insurance. That being said, many employers choose to offer coverage for spouses and families, regardless of whether dependents are older or younger than 26 years of age. In addition, most choose to subsidize a portion of the premium as well.

One trend picking up steam in the past decade is to only offer spousal coverage if the spouse isn’t able to obtain health insurance through his or her own employer (or if the spouse doesn’t work).

Another common practice is for an employer to levy an additional surcharge for spouses who can obtain insurance through their own employers, but prefer to be on their spouses’ insurance instead. The reasons for doing so are often wide and varied. Nevertheless, the surcharge is often relatively minimal — perhaps around $100.

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Topics: Employee Benefits, Affordable Care Act, Plan Design, employers

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5 Ways to Make Pregnancy (and the Return to Work) Easier for Working Moms

David Rook

Even though the majority of the working population in America are parents, employers seem to be largely in the dark about how to cater benefits packages to people who are raising kids, especially working moms. Thanks to the openness of the internet and highly successful working moms (like Sheryl Sandberg of Facebook) talking about their experiences, a whole new avenue of conversation has started about making the workplace more family-friendlyThe law provides a starting point, but there are little things (even free things) you can do to help make pregnancy and the return to work easier for working moms. 

First, a disclosure before I go on - I had a lot of help from my wife, a working mom of two children, when writing this particular article. She had a lot of thoughts about what she wished she would have had access to when our children were young and what employers could do now to make the return to work easier. With that out of the way, let's continue...

What’s Required of Employers by Law

Employers with 50 or more full-time equivalents are required to allow men and women to take up to 12 weeks of unpaid leave each year under the Family Medical Leave Act (FMLA). Most employers will allow their employees to use vacation or sick time during their leave so that part of the weeks are paid. Some even offer partially paid leave.

One of the provisions in the Affordable Care Act includes employer requirements for working moms who are still nursing. This stems from the scientific belief that breast milk, for the first year, is what’s best for babies, as well as the reality of breastfeeding — which is that it’s time consuming. Women are more likely to give up on breastfeeding if they don’t feel their employer is supportive of providing work breaks for pumping.

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Topics: Employee Benefits, Affordable Care Act, Compliance, Company Culture, Flexible Schedules

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How Does Healthcare in Europe Work?

David Rook

A photo of European currency with a doctor's stethoscope.The American healthcare system functions pretty differently than healthcare in Europe — and most healthcare systems in other first world countries, for that matter. With the ongoing healthcare debate in America (from repealing and replacing the Affordable Care Act to Senator Sanders’ Medicare-For-All proposal), many people have begun to ask why we can’t have a system like Canada, the U.K., France, or most other European nations. In order to decide whether or not those types of systems would be suitable for America (a debate we will not delve into here), we first have to understand how healthcare in Europe works.

How Healthcare in Europe Works

Generally speaking, most European nations (in addition to others around the world) have some type of universal healthcare. According to the definition provided by the World Health Organization (WHO), this means that everyone has equal access to quality healthcare that improves the health of patients and that seeking such care would not cause financial harm to those receiving it.

While it’s easy for Americans to generalize European healthcare into one giant conglomerate of universal coverage, there are actually many different systems across the continent. Each country has figured out their own way of organizing their insurance companies, doctors, and hospital systems. But regardless of country, healthcare in Europe is designed with the same goal in mind: to make sure every person has access to basic health services.

Given that European nations have all been around far longer than America, they’ve tried almost every possible scenario and, for the most part, they’ve landed largely on three systems: single-payer, socialized, and privatized, but regulated. Of course, there’s quite a bit of variety between countries and no two systems are alike.

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Topics: Employee Benefits, Affordable Care Act, ACA

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Why America's Healthcare System Is Broken

David Rook

According to The Commonwealth Fund’s most recent study of 11 different countries’ healthcare systems, the United States comes in dead last. This study measures overall industry performance and each country is ranked by five factors that contribute to their score: care process (in which the U.S. placed 5th), access (11th), administrative efficiency (10th), equity (11th), and outcomes (11th).

For being one of the richest countries in the world, the U.S. just can’t seem to get a grip on their healthcare system. No matter the proposed solution over the past century, the system has slowly but surely become more and more expensive, which means it’s also becoming less and less accessible.

If you were to ask 10 people why America’s healthcare system is broken, you’re sure to get 10 different answers — and you might even get into a debate about what “broken” means, both of which could help explain why we haven’t been able to fix it yet. Experts have many opinions, but one thing is for sure: the problems with our healthcare system don’t point back to just one cause. There are multiple issues at hand and none of them are easy fixes. 

5 Major Ways Our Healthcare System is Broken

Lack of Cost Transparency

One of the most common complaints among consumers is the lack of cost transparency in our healthcare system. You’d be hard-pressed to find another industry where this is the case. Even in other insurance situations, such as a car repair after an accident, the driver can figure out a fairly accurate estimate before ever paying a dime. The same goes for a homeowners claim.

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Topics: Employee Benefits, Affordable Care Act, Cost Containment, Education, ACA

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Healthcare vs. Health Insurance: Why the Difference Matters

David Rook

The term “healthcare” gets thrown around quite a bit these days. As HR professionals, you may have seen “healthcare” used interchangeably with “health insurance,” although it’s the layman doing so, rather than industry professionals. Healthcare and health insurance are two completely different things. They have different definitions, even though we, as a country, have largely co-mingled the two.

This co-mingling has led the county to erroneously focus on health insurance as an equal target of wrath for the rising cost of medical care, when in truth, healthcare has been the driving force. This understanding is critical if we’re to wrestle the ever escalating cost of medical care in this country.

Healthcare vs. Health Insurance

Healthcare

Healthcare is defined asthe field concerned with the maintenance or restoration of the health of the body or mind.” This also pertains to any “procedures or methods” related to the care of a person’s physical or mental health.

The industry in which medical professionals work is often referred to as the “healthcare industry.” Healthcare is provided by doctors, nurses, dentists, therapists, hospital systems, and pharmaceutical companies. The price these providers set for their products and services is the primary driver of health insurance costs.

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Topics: Employee Benefits, Affordable Care Act, Cost Containment, Education, PPACA

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What Is the Difference Between Group Health Insurance and Individual Health Insurance?

David Rook

With healthcare costs continuing to rise, small employers that aren't obligated to offer health/medical insurance per the Affordable Care Act’s (ACA) “employer mandate” have been dropping group coverage. This is a trend that started in 2009 during the recent recession. Some larger employers have also considered doing the same (though, they must pay steep ACA penalties if they do). At first glance, it might seem like this would bolster the health and stability of the individual insurance market. Despite the numbers of insured rising, however, increased costs and fewer options have put a serious squeeze on what was once a very healthy marketplace.

Group Health Insurance and Individual Health Insurance by the Numbers

Occasionally, a news piece predicts major shifts in the health insurance landscape, including dire predictions about employers dropping group health plans due to their high costs. However, it’s important to look closely at these numbers, as well as the size of the companies cited in the statistics.

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Topics: Employee Benefits, Affordable Care Act, Education, ACA

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Senate's ObamaCare Replacement Bill Would End Employer Mandate

Jeff Griffin

Determined to pass health care legislation before the July 4th break, the Senate on Thursday night released a draft ACA replacement bill called the Better Care Reconciliation Act (BCRA). As of this morning, at least five Republican Senators have said they won’t vote for the bill. GOP Senate leaders can only afford to lose two members of their 52-senator caucus in order for the bill to pass. (The loss of two would require Vice President Pence to cast the tie breaking vote, assuming not a single Democrat supports the bill.)

While passage as the bill stands now seems dubious, Republicans and the White House see this as one of the last chances they have to pass healthcare legislation before they can move on to tax reform, so amendments are likely to win back some of these Senators. That process, however, could push the vote to after the July 4 break. Still, Majority Leader Mitch McConnell is a seasoned politician, and many pundits doubt he’d call for a vote before the recess if he didn’t have a few aces up his sleeve.

Let's look at several elements of the bill which are particularly pertinent to employers:

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Topics: Employee Benefits, Affordable Care Act, ACA, Legislation, PPACA

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If the Employer Mandate is Repealed, Should Companies Drop Employer-Sponsored Healthcare?

Jeff Griffin

President Trump promised to repeal ObamaCare on “day one”. While it’s going to take a little longer than he had planned, it does look inevitable that an overhaul to the Affordable Care Act (ACA) will eventually pass both houses of Congress, even despite recent legislative setbacks.

One of the least popular provisions of the law, at least for employers, is the “employer mandate”, which requires certain employers with 50 or more “full-time equivalent” employees (FTEs) to provide an affordable healthcare plan. With the proposed law as it stands today, now in jeopardy, a pressing question is now looming over employers: if the employer mandate really is repealed, should they drop their health coverage?

The issue certainly isn’t cut and dry, with some believing that no matter what happens in Washington, employer-sponsored healthcare is dying and others predicting it will never really go away. Assuming the ACA’s employer mandate is repealed, every company will have an important decision to make, weighing the benefits and pitfalls of dropping coverage.

Repealing the Employer Mandate

Republican lawmakers have spoken on countless occasions about wanting to repeal the employer mandate. The Trump administration even ran on a platform of getting rid of it. In theory, this doesn’t seem like a big deal, but in practice, it’s more difficult than it seems. The employer mandate, after all, is the primary mechanism by which healthier people are brought into the overall risk pool, which is the only way a healthy insurance market works (healthy people subsidize the unhealthy, essentially). Without it, most experts predict that insurers would pull out of the healthcare exchanges and the entire program will collapse.

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Topics: Employee Benefits, Affordable Care Act, ACA, Employer Mandate, Employee Retention

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What Are Required Employee Benefits?

David Rook

When starting a business, most entrepreneurs want to attract employees by offering them a robust benefits package. Then, reality sets in, and they realize that this will have to wait until they establish positive cash flow. Well regardless of if an employer is just starting out or if they’re already well established, employers need to realize that there are certain required employee benefits they MUST offer in order to maintain compliance with the law; failure to do so can trigger large penalties. Here are required employee benefits employers cannot skip — and some that are only applicable as a business grows.

Required Employee Benefits For Employers of Any Size

1. Social Security and Medicare Benefits

Every employer, regardless of size, is subject to the required employee benefit of matching their employees’ social security and Medicare contributions. The current rate for social security is 6.2 percent of the employee’s wage from each party, equalling 12.4 percent in total, up to the first $127,200 in earnings. This amount is also known as the “wage base limit.”

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Topics: Employee Benefits, Affordable Care Act, employers

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